Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CH108170 Dirne Health Centers, Inc.

Covered Entity Details

Entity Name

Dirne Health Centers, Inc.

Subdivision Name

Heritage Health CDA

Type

HRSA-Funded Health Center

340B ID

CH108170

Entity Address

1090 W Park Pl
Coeur D Alene, ID 83814-2785

Grant Number

H80CS02331

Participating Start Date

4/1/2004

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #6200
43 WEST PRAIRIE SHOPPING CTR
HAYDEN, ID 83835

Pharmacy Comments

Contract Details

Approval Date

4/13/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Michael Baker, CEO
(208) 292-0256

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

4/13/2019

340B Drug Pricing Program Database